Respi

Upper Airway ●

Nose – – –

Nares/nostrils – opening of the nose Nasal septum – separates the right and left sections of the nose Vibrissae – hair follicles that filters the inspired air

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Oral Cavity – – – – – –

An alternative portal of entry for air into the respiratory tract. Main function: to move food from the mouth into the esophagus in the process of swallowing. Vestibule – the outer portion of the oral cavity that consists of the lips, gums and teeth. Hard and soft palate Tonsils – play a role in immune defense and protection from foreign matter. Uvula – fleshy appendage that hangs down from the soft palate.

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Pharynx – – –

Nasopharynx Oropharynx Laryngopharynx ●

Serves as a conduit to the lower airways

Lower Airway and Lungs ●

Lungs – cone-shaped, spongy structure with a narrow end at the top and wide bases at the bottom. –

Surface area: about the size of a tennis court (approx. 70 – 100 m2)

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Larynx – also known as voice box –

Functions: ●

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Provide a pathway for airflow from the upper airways into the lower airways To separate air from food or liquids preventing aspiration Serve as a site for resonance of spoken voice

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Trachea – composed of C-shaped cartilaginous rings that provide firm support. Bronchi – large, cartilage-containing airways that serve as the central passageway to the right and left lungs.

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Alveoli – tiny grapelike sacs – – –

serves as functional unit where gases are exchanged. Alveolar capillary interspace – separates the alveolus from the pulmonary capillary Pores of Kohn – small openings between the alveoli

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Pleura– provide a cover for the lungs and line the thoracic wall. Composed of: – –

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Visceral pleurae – cover the lung parenchyma Parietal pleurae – cover the outside of the lungs and are in contact with the thoracic cage

Pleural space – contains serous fluids that allows the layers to move easily and without friction during normal ventilation

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Thoracic Cage – –

Maintain pressure and tension that are necessary for normal ventilation

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Mediastinum – houses the trachea, esophagus, heart, pulmonary lymphatics, great blood vessels and thymus glands

Substances important in maintaining alveolar integrity 1. Surfactant – – –

acts to lower surface tension and prevent collapse of the alveoli. Promotes expansion and stability of the alveoli. Protective, waterproof material that may prevent the movement of fluid across the alveolar-capillary membrane during the respiratory cycle.

2. Alpha 1- antitrypsin –

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A glycoprotein produced by the liver that plays a significant role in maintenance of the pulmonary tissue Primary function: inhibit natural proteolytic enzymes

Respiratory Muscles ●

Inspiratory Muscles –

Diaphragm– the major muscle in the act of breathing ●

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Able to facilitate lung expansion by moving downward during inspiration.

External intercostal muscles – located between the ribs ●

Able to further enlarge the thorax during inspiration by creating an upward and outward motion of the lower ribs.

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Scalene and sternocleidomastoid muscles –

Used during labored breathing to raise the first two ribs and sternum in an effort to increase the size of the thoracic cavity.

Respiration

-provides the body with a means of gas exchange

can be divided into 3 parts: a. Ventilation b. Perfusion c. Diffusion

Ventilation -movement of air between the atmosphere and respiratory portion of the lungs Control of breathing: 1. Central Receptors *medulla oblongata *pons 2. Chemoreceptors 3. Lung Receptors

Lung Receptors a. Stretch receptors -respond to changes in pressure in the walls of the airways. -location: smooth muscle layers Inflation reflex Hering-Breuer reflex – serves to regulate the depth of breathing by limiting lung inflation. b. Irritant receptors Stimulation leads to airway constriction Location: airway epithelial cells

c. Juxtacapillary or J receptors -sense lung congestion -responsible for rapid shallow breathing that occur with pulmonary edema, pneumonia. Location: alveolar wall

Perfusion

-the flow of the blood through the lungs

Diffusion -transfer of gases between the air-filled spaces in the lungs and the blood

Gas Exchange and Gas Transport

Oxygen is transported in two forms: 1. chemical combination with hemoglobin Hemoglobin -serves as a transport vehicle for oxygen. -it binds oxygen in the pulmonary capillaries and release it in the tissue capillaries. - 1gm of hemoglobin= 1.34ml of oxygen 2. dissolve state (1%) Ratio of Oxygen dissolve: *for every 1mmHg of PO2 present in the alveoli, 0.003ml of O2 becomes dissolved in 100ml of plasma

Carbon dioxide Transport

CO2 is transported in 3 forms: 1. As dissolved CO2 (10%) 2. attached to hemoglobin (30%) 3. as bicarbonate (60%)

*lungs restore the oxygen content of the arterial blood and remove carbon dioxide from the venous blood.

*The blood carries oxygen and carbon dioxide in a dissolve state and combination with hemoglobin.

*Oxygen and carbon dioxide are dissolved in plasma.

ALTERATIONS in RESPIRATORY SYSTEM and FUNCTION

Respiratory Tract Infection

Common Cold -viral infection of the upper respiratory tract which is usually lasts for 7 days. -period of communicability: first 3 days after the onset of symptom S/S: a. headache b. generalized malaise c. fever d. exhaustion

Sinusitis -inflammation of paranasal sinuses -classified as: a. acute- lasts from 1day to 3weeks b. sub acute- 3weeks to 3 months c. chronic- 3 months and beyond S/S: a. facial pain b. headache c. purulent nasal discharges d. fever e. decrease sense of smell

Influenza -viral (influenza A and B) infection that can affect both the upper and lower respiratory tracts. -incubation period: 1-4days; 2 days being the average -period of communicability: 1st day to 5th day of illness S/S: a. abrupt onset of fever and chills b. malaise and muscle aching c.headache d. profuse,watery nasal discharges e. non productive cough f. sore throat

Pneumonia -inflammation of parenchymal structure of the lung, such as the alveoli and bronchioles -can be atypical (viral) and typical (bacterial) -classified as: CAP and HAP

S/S: a. chills b. fever c. severe malaise d. purulent sputum e. elevated WBC f. patchy or lobar infiltrates

Tuberculosis -infectious disease caused by the M. Tuberculosis a. M. Tuberculosis hominis (human tuberculosis) b. M. Tuberculosis Bovis (bovine tuberculosis) -acquired by drinking milk from infected cows.

S/S: a. low grade fever b. night sweats c. dyspnea/orthopnea d. easy fatigability e. f. weight loss g. cough initially dry but later become productive with purulent/blood tinged

Disorders of Lung Inflation

Pleural Effusion -abnormal collection of fluid in the pleural cavity -the fluid may be a transudate (hydrothorax), exudate, purulent drainage, blood (hemothorax), emphyema (pus).

*normally, only a thin layer (<10ml-20ml) of serous fluid separates the visceral and parietal layers of the pleural cavity.

S/S of Pleural Effusion: a. dullness, flatness during percussion b. diminished breath sounds c. dyspnea d. pleuritic pain e. mild hypoxemia

Pneumothorax -air enters the pleural cavity -may be classified as:

a. Spontaneous Pneumothorax -occurs when an air-filled bleb or blister in the lung surface

b. Traumatic Pneumothorax -may be caused by penetrating or nonpenetrating injuries (fracture and dislocation) c. Tension Pneumothorax -occurs when the intrapleural pressure exceeds atmospheric pressure (atelectasis)

S/S of pneumothorax: a. chest pain b. increase RR c. dyspnea d. increase HR e. asymmetry of the chest f. hyprresonant sound g. hypoxemia

Atelectasis -refers to the incomplete expansion of the lung or portion of a lung. Manifestations: a. tachypnea b. tachycardia c. dyspnea d. cyanosis e. hypoxemia f. diminished chest expansion

Obstructive airway Disorders

Bronchial Asthma -chronic inflammatory airway disease -caused by allergens, RTI, emotional upsets, chemical, etc. S/S: airway obstruction characterized by: a. wheezing b. breathlessness c. chest tightness d. cough

COPD -denotes a group of respiratory disorders characterized by chronic and recurrent obstruction of air flow in the pulmonary airway.

1. Emphysema (pink puffers) -characterized by lung elasticity and abnormal enlargements of air spaces distant to the terminal bronchioles with destruction of the alveolar walls and capillary beds. -Causes: smoking Antitrypsin deficiency

2. chronic Bronchitis (blue bloaters) -obstruction caused by inflammation of the major and small airway.

Pink Puffer

S/S: a. dyspnea b. increased ventilatory effort c. barrel chest d. pursed lip breathing noted e. weight loss

Blue Bloaters S/S: a. hypoxemia b. cyanosis c. shortness of breath d. prolonged expiratory respiration e. pulmonary hypertension f. cor pulmonale g. clubbing of fingers

3. Bronchiectasis -abnormal dilation of the large bronchial associated with infection and destruction of the bronchial walls. 4. Cystic Fibrosis - an autosomal recessive disorder involving secretion in the exocrine glands, and epithelial lining of the respiratory, GI and reproductive tract.

S/S: a. chronic respiratory disease b. pancreatic exocrine deficiency (pancreatitis) c. elevation of sodium chloride in the sweat d. nasal polyps e. accumulation of viscid mucus in the bronchi

THANK you for listening Enjoy the rest of the nyt=).....be safe..god bless

Ms. Obenza